Haven Hub — Youth Group

Your Details

Full Name *

Please enter your full name.

Your Phone Number *

Please enter your phone number.

Your Email Address *

Please enter a valid email address.

Date of Birth * Used to confirm eligibility and assign you to the right group.

Please select your date of birth.

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Give Us a Call

Our youth groups are open to young people aged 13 and over. If you're under 13 and would like to know more about Haven Hub, please get in touch directly.

✉️ info@havenhub.ie

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Our Youth Groups Are for Ages 13–30

Our funded youth programme is open to people aged 30 and under. Haven Hub offers a range of other supports — get in touch and we'll make sure you get what you need.

✉️ info@havenhub.ie

Parent / Guardian Details

Parent / Guardian Full Name *

Parent/guardian name is required.

Relationship to You *

Please select the relationship.

Parent / Guardian Email * A consent email will be sent here.

A valid parent/guardian email is required.

Parent / Guardian Phone *

Parent/guardian phone number is required.

Emergency Contact

Next of Kin Name *

Next of kin name is required.

Relationship to You *

Please select the relationship.

Next of Kin Email *

A valid next of kin email is required.

Next of Kin Phone *

Next of kin phone number is required.

About Your Interest

Why are you interested in joining The Haven Hub Youth Group? *

0/500

Please tell us why you'd like to join.

Are you passionate about mental health and wellbeing? *

Yes, very much so Not particularly, but I'm interested in the group

Please select an option.

Getting Involved

Would you like to take on a role in the group? Optional — e.g. social media, budget, arranging activities, taking minutes.

What evenings or days suit you best? * Weekday evenings or weekdays.

Please tell us your availability.

Do you have any additional needs we should be aware of? * We welcome everyone and want to make sure we meet your needs.

Please fill this in (write 'None' if not applicable).

Any additional comments?

Permissions & Consent

WhatsApp Contact Permission * May we contact you via WhatsApp about the group and add you to relevant group chats?

Yes, you can contact me via WhatsApp No, please don't contact me via WhatsApp

Please select an option.

Photo & Video Consent * From time to time we take photos and videos at group activities. These may be shared with our funders and on social media.

Yes, you have my permission to include me in photos/videos No, please do not include me in photos/videos

Please select an option.

Data Storage Consent * I consent to Haven Hub CLG storing my personal information for the purpose of administering my membership of the youth group, in accordance with their Privacy Policy.

You must consent to data storage to register.

Review Your Registration

Please check your details above before submitting. Use the Back button to make corrections.

You're registered!

Thanks for registering with Haven Hub Limerick Youth Group.

HH-YTH-2026-XXXX

Keep this reference for your records.